An implementation of a NTP guidelines, as the DOT program need to be reviewed from more perspectives.

1. Public Health Officers’ Perceptions and Facilitators’ Experiences
of the Implementation of the DOT Program Management
in Trang Province, Thailand
Introduction
Thailand is 18th out of the 22
countries with the highest
tuberculosis burden. It is a
challenge to achieve the UN
Millennium Development
target for TB as well as the new
targets by WHO to stop TB for
the year 2035th.
Improving the outcome of the
DOT program, requires
knowledge how the provincial
leadership, by Public Health
Officers (PHOs) perceive the
management system, and how
their facilitators, Village
Health Volunteers (VHVs) and
family members experience
how it is carried out.
Method
Individual interviews were
conducted with PHOs (n= 10 ).
A phenomenographic analysis
was used.
Five Focus groups were
conducted with the VHVs and
Family members (n= 31).
Content analysis were used.
Conclusion
• An implementation of a NTP
guidelines, as the DOT
program need to be reviewed
from more perspectives within
a framework.
• The perspectives from the
leadership and facilitators
about how the management
system is carried out is an
essence.
• The leadership perceived
practical dilemmas and a need
of improvement towards a
new practice.
• The facilitators need to get
more knowledge how to
empower the patients instead
of controlling.
• Next step in this project is to
get the patients themselves to
be listen to and give their
opinions before a proposal of
ways of improvement will be
made.
Jiraporn Choowong1, Per Tillgren2, Maja Söderbäck3
1 PhD. student, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna-Västerås, Sweden
2 Professor, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna-Västerås, Sweden
3Associate professor, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna-Västerås, Sweden
Results
As leaders the PHOs’ described
the wish to comply with the
National TB program (NTP)
guidelines to achieve a
successful treatment. But they
perceived some practical
dilemmas which made it
difficult. They saw a need for
improvement in management
system.
The facilitators' described to
carry out the DOT program to
TB patients as a transition
process from illness to cure.
The experiences included both
monitoring and promoting
activities.
Figure 1. The leaders’ perceptions and the facilitators’ experiences about the implementation
of the DOT program management system for TB control in Trang province, Thailand
Aim
The aim of this project was to
explore PHOs perceptions of
the management of the DOT
program in Trang province,
Thailand, as well as the
facilitators (VHVs and family
members) experiences.
• Achieving a successful
cure
• Compliance with the
NTP guidelines
• Need for improvement:
• New practice guidelines
• Practical dilemmas:
• Fear of infection
• Mistrusting each other
• Inadequacy of TB
knowledge
Time span
with
critical
points
Cooperating
Promoting
activities
Monitoring
activities
No. P067SA
JIRAPORN CHOOWONG
Doctoral candidate,
School of Health, Care and
Social Welfare ,
Mälardalen University
Jiraporn.choowong
@mdh.se, www.mdh.se/hvv